UHN Blog: What’s the Right Blood Pressure for You? It Depends

Experiencing high blood pressure symptoms? Changing recommendations in recent years stress the individualized nature of blood pressure control.

The "right" blood pressure isn't necessarily the same number for all of us. Too many factors come into play, as our blogger describes.

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Aside from the occasional aches, pains, and sleeping troubles, my 82-year-old mother is in very good health for her age. But like many other older adults, she takes a medication to help control high blood pressure symptoms. And like plenty of older individuals, she relies on her doctor to let her know whether her current blood pressure readings are appropriate or whether greater effort is needed to bring them down even further.

But the right blood pressure target has been…well, a moving target in recent years. Before we go through the shifting recommendations, here’s a quick primer on high blood pressure.

WHAT YOU SHOULD KNOW

Want to know more about what your blood pressure numbers mean? See our post “Blood Pressure Chart: Where Do Your Numbers Fit?

Blood pressure is the force of blood against the inside walls of your arteries. High blood pressure (hypertension) is defined as a systolic pressure of 140 mm Hg or higher and a diastolic pressure of 90 mm Hg or higher. The “mm Hg” refers to millimeters of mercury. Systolic is the “top” number in your blood pressure, and diastolic is the “bottom” number. So if your blood pressure is 119/70 mm Hg (good for you, by the way!), your systolic pressure is 119 and your diastolic pressure is 70.

A systolic pressure of 120 to 139 or a diastolic pressure of 80 to 89 is considered prehypertension—a warning stage that you need to take steps to avoid full-blown hypertension. A normal or healthy blood pressure is a systolic pressure of under 120 and a diastolic pressure of under 80.

Seems pretty straightforward, right? Not exactly.

Reading Into Blood Pressure Symptoms

While the actual definitions of normal, prehypertension, and hypertension are still technically the same, the recommendations for what certain groups of people should aim for are the subjects of some debate.

The American Heart Association (AHA) and the American College of Cardiology (ACC) have recommended for some time that healthy adults under 80 should strive for a blood pressure of less than 140/90. But healthy adults 80 and older have a little more leeway. The AHA and ACC recommend that this older population should get their blood pressure below 150/90.

However, in 2014, a panel of experts drafted a set of recommendations that was published in the Journal of the American Medical Association (JAMA). Among the key suggestions: Healthy adults under 60 should aim for blood pressure of under 140/90, and those older than 60 should try to keep their blood pressure under 150/90.

The JAMA recommendations, as you might imagine, triggered debate. Some experts argued that those higher limits are safe for individuals who are otherwise healthy, and that taking multiple medications to drive down your blood pressure and address blood pressure symptoms can increase the risk of side effects.

One of the biggest risks of aggressively trying to lower a person’s blood pressure is that multiple medications can work too well. A sudden drop in blood pressure can lead to the three F’s: fainting, falls, and fractures.

blood pressure reading

What is high blood pressure, or hypertension? It’s a systolic pressure (top number) of 140 mm Hg or higher and a diastolic pressure of 90 mm Hg or higher. This reading, 120/80, is a good goal, but as author Jay Roland notes, “What’s right for you may not be right for your best friend, even if you’re both the same age.”

But other experts say that making 150/90 as a ceiling for high blood pressure in anyone 60 and older is just too high. They believe that this more relaxed target could be a serious health risk for many people. High blood pressure is a leading cause of stroke, heart attack, heart failure, and other serious cardiovascular problems.

The argument for really lowering your blood pressure got a big boost in the fall of 2015 in a study known as SPRINT (Systolic Blood Pressure Intervention Trial). Among the findings of SPRINT were that adults 50 and older had significantly lower rates of a composite of heart attack, heart failure, stroke and death from any cause when they were treated with medications to get their systolic pressure below 120, compared with those just trying to keep their systolic pressure under 140.

Not surprisingly, plenty of doctors spoke out in favor of the SPRINT findings, while others said the risks of pushing blood pressure down below 120 may be worse than the risks of having blood pressure closer to 140.

The Bottom Line on Blood Pressure

So what’s the answer? What should be my mom’s target blood pressure? What should yours be?

Well, if you have diabetes or kidney disease, for example, you should try to keep your blood pressure below 130/80. If you have a history of stroke or heart disease, you should also try to lower your blood pressure if you’re normally in that 150/90 region. If you’re younger than 60 and in good overall health, you should try to get your blood pressure under 120/70.

But if you take multiple medications every day for other health problems, adding additional anti-hypertensive drugs daily to get your blood pressure down a few more mm Hg may lead to drug interactions that put you at greater risk than an elevated blood pressure.

The bottom line is this: Lower blood pressure is better than higher blood pressure. But what’s right for you may not be right for your best friend, even if you’re both the same age. Blood pressure management is an individualized endeavor. It depends on your personal health history, any family history of high blood pressure or cardiovascular disease, your weight, age, diet, the amount of exercise you get, your smoking history, and whether you have conditions such as diabetes or kidney disease.

No smoking

Give yourself a healthier blood pressure by avoiding cigarettes, eating a healthy diet, and getting regular exercise.

So talk with your healthcare provider about your risks, as well as what lifestyle changes you can make that can help improve your blood pressure. Try to decrease the sodium in your diet—less than 2,300 mg daily or 1,500 mg if you have established hypertension. Get 30 to 40 minutes of exercise daily. Quit smoking. Manage stress through yoga, breathing exercises, or avoiding stressors in your life. And if you’re overweight, lose weight. Even dropping five to 10 pounds can often make a difference in your blood pressure.

Even with a healthy lifestyle, controlling your blood pressure can often require more than one medication. But as I remind my mother, exercise and a healthy diet can help those medications do their job.

And whatever you do, don’t stop taking your blood pressure-lowering medications once you arrive at your desired target. The reason your numbers are where they should be is because you’re taking your pills and doing all the other things the right way. High blood pressure isn’t like a broken bone that heals and doesn’t need any more attention. It’s a lifelong commitment that requires your best efforts and the best guidance your healthcare provider can offer.

stretching exercises

Regular exercise is proven to help keep your blood pressure in check. The Centers for Disease Control & Prevention recommends 150 minutes of exercise per week. “We know [that] sounds like a lot of time, but it’s not,” as the CDC’s website notes. “That’s 2 hours and 30 minutes, about the same amount of time you might spend watching a movie. The good news is that you can spread your activity out during the week, so you don’t have to do it all at once. You can even break it up into smaller chunks of time during the day. It’s about what works best for you, as long as you’re doing physical activity at a moderate or vigorous effort for at least 10 minutes at a time.”

OUR BLOG LOG

Besides authoring informative, straightforward, easy-to-understand posts on a variety of medical issues, conditions, and treatments, our consumer health experts use a personal touch to help inform you via our series of UHN blogs.

  • Aging & Independence: “What’s Ailing You? We’re All Ears” by Timothy Cole
  • Bones & Joints: “Emergency! Coping with a Broken Ankle Overseas,” by Timothy Cole
  • Cancer: “A Crusade Against Cancerous Moles,” by Jim Black
  • Digestive: “Blood Tests, My Liver, and Me,” by Timothy Cole
  • Eyes, Ears, Nose, & Throat: “Antibiotics Are Over-Prescribed,” by JoAnn Milivojevic
  • Eyes, Ears, Nose, & Throat: “How to Get Through Allergy Season,” by Jay Roland
  • Heart Health: “What’s the Right Blood Pressure for You?” by Jay Roland
  • Nutrition: “What Is Nutrition?” by Dawn Bialy
  • Pain: “How to Relieve Lower Back Pain,” by Kate Brophy
  • Pain: “Is Your Kidney Stone Pain a Single Episode… or Chronic?” by Timothy Cole

Originally posted in 2016 and regularly updated.

Comments
  • I was getting readings of 98/60 or 100/61 and feeling dizzy. Doc lowered the dosage now and the readings are more normal but sometimes higher. One of my readings was at 98/58
    at my therapists and she got worried. I used to be textbook 120/70 until Mom got dementia.
    Talking about her raises my BP.

    Reply
  • The most complete, balanced and understandable treatise on blood pressure that I have seen to date.

    Reply
  • Surprisingly consuming two bananas per day can lower your blood pressure by 10 %. This is best home remedy to live a little longer.

    Reply
  • This is such BULLSHIT and designed to sell more drugs like Lisinopril that had had 15,000 complaints in the last 5 years. Some of them drastic like ‘total kidney failure’ and suicide. Why are millions of American on blood pressure medication. I’ve thrown mine in the trash. I can now think straight, my tingling in my feet is going away slowly, I don’t wake up with stiff hands and feet anymore. If I have a stroke which no one can substantiate is caused by hbp, at least it will be on me and I will have a better quality of life till then.

    Reply
  • My blood pressure is all over the map, but I have learned what to do and not do. In the afternoon it drops way down, and I go to bed to let it recoup. I keep a record of it, but the doctors ignore me when I try to talk to them about it. I eat healthy, and exercise daily including three floors of stairs up & down., and 3 long halls both ways. I am 86 years old, 5’6″, 105 lbs.

    Reply
  • This posting is devoid of anything useful.
    If anything it encourages the use of health depleting blood pressure medication.
    NOTE: On a related topic statins have been shown to directly cause dementia in some people

    Reply
  • I have high cholesterol, trig, etc I am 77 years old I have bad bones I know my doctor will prescribe a pill could u please tell me what pill would least effect my bones or if u have any other suggestions I have done the low carb diet and it definitely worked but I don’t stay on it any suggestions

    Reply
  • Eating too much sodium over time can increase your risk of high blood pressure, which is a major risk factor for heart disease. For a healthy heart, it’s important not to eat too much salt.

    To reduce blood pressure and lower the risk of heart disease, the Heart Foundation recommends adults eat less than 5g of salt (2000mg of sodium) a day. That’s less than a teaspoon a day.

    Talk with your doctor or health practitioner about what’s right for you.

    High dietary intakes of salt can lead to high blood pressure. Reducing salt in your diet can reduce your blood pressure, however, the extent to which it does depends on age, physical activity levels, weight and stress.
    I am always trying to get cheap and reliable meds online and of course get them easily on amazon, mygenericpharmacy and healthkart etc

    Reply
  • I had high blood pressure for 20 years, but we could never find the cause of it, and no Western medicine ever managed to reduce it. I am accustomed to take ramipril 5 mg, it does not work very well. I see the doctor every week. I was full of worry. I need advice and some direction. While surfing the internet I stumbled upon a testimony from someone who had high blood pressure got heal. I was more than willing to try it. I contacted the doctor I was lucky when I received a response from Dr.fabien. I followed your instructions, I used this Herbal Medicine in less than 1 week, my blood pressure is now normal!  totally free on side effects. Thank goodness for a wonderful doctor, Anyone living with unexplained high blood pressure needs to use this herbal medicine.

    Reply
  • To prevent high blood pressure, everyone should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking, and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 130/80 in people older than age 65 and those with risk factors such as diabetes and high cholesterol.

    it is important for a person to follow a doctor’s instructions on how to treat skin problems and always buy prescribed meds only. There are too many online stores offering meds online like amazon, healthkart, and mygenericpharmacy etc which are most popular.

    Reply
  • The category of medication your doctor prescribes depends on your blood pressure measurements and your other medical problems. It’s helpful if you work together with a team of medical professionals experienced in providing treatment for high blood pressure to develop an individualized treatment plan.
    Nowadays there aretoo many online stores but all are not reliable, they are selling cheap meds only but result is not concern for them, i am only visiting reputed online store like mygenericpharmacy.

    Reply

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